• Journal of Korean Academy of Nursing Administration
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• v.7 no.2
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• pp.265-284
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• 2001

The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.25-37
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• 2005

Objective : To estimate the magnitude of psychosocial distress and examine eligible factors associated with the development of psychosocial distress in Korean employees, using a nationwide sample. Methods : A total of 6,977 workers were recruited from 245 companies. A structured questionnaire was used to assess sociodemographics, health-related behaviors, job characteristics, social support at work, personality traits (locus of control, type A behavior pattern), self-esteem, and psychosocial distress. Results : The results showed that 23 % of workers were categorized as high stress, 73% as moderate, and 5% as normal. Hierarchical multiple regression analysis showed that psychosocial distress was more common in younger workers, both male and female. Regular exercise was negatively associated with increase of psychosocial distress. In job characteristics, as expected, low decision latitude, high job insecurity, and low social support at work were related to high psychosocial distress. Personality traits such as locus of control and type A behavior pattern, and self-esteem were more powerful predictors of psychosocial distress than general characteristics, health-related behavior, and job characteristics. There were some gender differences. While men who are less educated and single (unmarried, divorced, and separated) experienced higher levels of psychosocial distress than those who are educated and married, women who feel high job demand experienced higher levels of psychosocial distress than those who feel low job demand. Conclusions : The proportion of the high stress group was higher than expected, and psychosocial factors like social support and personality characteristics (e. g. locus of control, type A behavior pattern and self-esteem) were more significant factors for psychosocial distress than other variables. This finding suggests that some psychosocial factors, especially inadequate social support, low self-esteem and lack of internal locus of control for the development of psychosocial distress, will also operate as an intervention strategy in the worksite stress reduction program. It is strongly required that worksite stress reduction programs should be established in at both occupational and level as well as in individual levels.

• The Korean Journal of Air & Space Law and Policy
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• v.33 no.1
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• pp.147-174
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• 2018

The air transportation industry is a field where control and interference of the state are generalized compared to other industries. However, the premise for national intervention in the air transportation industry is the determination of the nationality of the aircraft or airline company concerned. This is because it is necessary to clarify the distinction between the domestic and foreign carriers so that they can exercise airspace sovereignty. The purpose of this paper is to compare the current status and contents of Korean law and regulations on the determination of nationality with the foreign legal system. To this end, the starting point of the discussion is to look at the history of nationality restrictions on the US air transport industry and the issues that arise in the content and operation of the system today. In addition, this paper examined the provisions of the Japanese aviation law, which is very similar to that of Korea, and then compared the current legal provisions of the United States, Japan and Korea. As a conclusion, this paper sought the direction of revision of the Korean law on the basis of the foreign status of the restriction of nationality in the air transportation industry. Compared with our law, the US and Japan are generally regarded to be more concerned with the contents of their own airline companies than those of foreigners or non-citizen. In spite of the fact that there are many laws and regulations in the United States regarding the de facto dominance of domestic airline companies by foreigners, there have been a lot of controversies in this matter. By the way, Japan has been stipulating regulations on holding companies and affiliated companies. In the global era, it would be meaningful to check the status of the nationality restrictions in the aviation industry, which is based on internationality. I hope that this study will be able to build a legal institutional basis for Korea's aviation industry development from a reasonable protectionist point of view rather than a narrow nationalism in a rapidly changing era.

• 한국노년학
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• v.38 no.3
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• pp.551-567
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• 2018

Demographic and socio-structural information is useful to identify potential welfare recipients who are in need of disease-prevention and intervention services. Thus, the present study aims to explore the differences in grip strength among middle and old-aged adults by living conditions and by living area. The 5th wave data of Korean Longitudinal Study of Aging was utilized. The dependent variable was grip strength, and the independent variables were living alone (living alone or not) and living area (city or non-city). Covariates were age, education, log-transformed household income, spouse existence, body mass index, self-rated health conditions, depressive symptoms, cognitive function, smoking, regular exercise, frequency of meeting with friends, and the number of social participation. Regression analysis was performed for middle-aged men, middle-aged women, old-aged men, and old-aged women, respectively. ANOVA and Chi-test were additionally used to specifically discuss significant results. Cross-sectional weight was applied to all analyses. According to the results, living alone and living area did not have significant effects on grip strength among middle-aged men, old-aged men, and old-aged women. In middle-aged women, however, living alone and living area were significantly associated with grip strength. To be specific, middle-aged women who lived alone in rural areas had the lowest grip strength compared to other middle-aged women. Additional analysis showed that middle-aged women who lived alone in rural areas had risk factors, such as low education level, low income, or high depressive symptoms. It implies that middle-aged women living alone in rural areas may have physical health risks, so they might be in need of disease prevention. This study is meaningful in that it can provide reliable information on the latent welfare recipients by using representative panel data and applying weight values.

• (The)Study of the Eastern Classic
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• no.73
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• pp.385-414
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• 2018

In this article, the women as the subject of the family management in the 19th century cataclysm, In particular, I tried to reconstruct the specific life course of a woman who has a status as a jongbu(종부) in the Korean language through the Hangul letter. The Haenam Yoon's the 8th jongbu(종부) Gwangju Lee attempted to find her own unique identity, not the male-centered social order she had learned. Because she had to live a life outside the traditional environment of traditional society because her husband died at the beginning of her marriage. She perceived herself as an independent subject that she had to find and maintain. When Gwangju Lee married and came to the family of Haenam Yun, the economic power of jong-ga(종가) was much inclined. This economic difficulty was caused by the conflict with the slaves and the decrease of tallage(地代) to the change of the slavery system which was the social flow at that time. And uncles of her husband's intervention made the economic situation of the family more difficult. She established her position as a jongbu(종부) and used the right of Adoption option(입후권) of the jongbu(종부) to establish the impoverished family. She chose adoption from distant relatives who were not children of her husband's uncles. Therefore, I was free from her husband uncle's interests. She also believed that it was most important to take control of the economic interests of her family in order to secure her authority as a jongbu(종부). She believed that she had to exercise her economic rights in order to bring slave labor, which is the most important means of sustaining the domestic economy at the time, In the absence of her husband, she established her family in the social upheaval of the nineteenth century, and took her place as a master of a family, not just a family name.